Notice

Customer Service will be closed on Friday, April 18, 2025 for Good Friday. We apologize for any inconvenience this may cause.

To view benefit information and claim status, self-service by signing into your account or using our Interactive Voice Response System (IVR) 24/7 at 800-452-9310.

Small Group Forms for Brokers

Easily access and download all the small group forms and applications.

Small Business Dental Plan Forms for 2-50 Enrolled Employees

Easy employer application (PDF, 9 pages, 1,930 KB)
Download our easy group application for 2-50 business

Simple dental employee enrollment (PDF, 1 page, 204 KB)
Download our easy dental group enrollment form for 2-50 business

Simple vision employee enrollment (PDF, 1 page, 204 KB)
Download our easy vision group enrollment form for 2-50 business

Enrollment spreadsheet (Excel)
Download our easy group enrollment spreadsheet guide for 2-50 business